Immediate Risks and Disruptions

PEPFAR Programme Delays:

• PEPFAR PrEP delivery to 2,500 people among key populations, mainly men who have sex with men, was canceled. However, as of 14 March PrEP provision services for key populations (MSM mainly) have been re-established and the MoH has taken over distribution.
  • Human resources and transport for viral load samples at ARV clinics provided by PEPFAR were canceled, affecting several cities:
    • Panama City: 8,100 people
    • Colón: 1,300 people
    • Pacora: 300 people
    • Ngäbe-Buglé population: 1,400 people, where HIV prevalence is high.
  • HIV commodities: Stocks available with minimal disruption.
  • Prevention of vertical transmission (PVT) and pediatric HIV services: No services affected.
  • HIV prevention: Disruptions in access, reduced capacity for HIV prevention services, including HIV counseling and testing, primarily affecting sex workers, men who have sex with men, and transgender people.
  • Condom promotion and demand generation activities: Impact noted on public sector, social marketing programs, NGOs, and community distribution.
  • Data collection: Continues at some facilities and service points, along with some data quality control and collation.
  • Study suspension: The suspension of a study on recent HIV diagnoses and the halt in laboratory sample transportation have further limited essential diagnostic and monitoring services
  • All programs on stigma and discrimination have stopped, affecting key populations. Communities have collected data on human rights issues, including increased stigma and discrimination.
  • Disruptions noted in HIV prevention programs affecting particularly men who have sex with men, sex workers and transgender people

Service Disruptions:

Politically Relevant Updates

1. Government Actions:
   • The Panamanian government began expanding friendly services to key populations to absorb the demand for PrEP that US funding was covering.
   • Adjustments were made to ARV services to temporarily cover the human resources provided by US funding, however, this impacted the quality and timeliness of service provision.
2. Civil Society Impact:
   • Community-based organizations (CLOs) are struggling but have alternative funding sources; however, they have noted a reduced ability to participate in policy discussions.
3. UN Response:
   • A country-level task team has been established but does not include representatives from people living with HIV and key population networks.
   • UNAIDS is collecting information from PEPFAR partners but has not received clear responses due to canceled field worker contracts.